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Bone problems

If your kidneys are severely damaged, you can get a build-up of phosphate in your body because your kidneys cannot get rid of it.

Along with calcium, phosphate is important for maintaining healthy bones. But if your phosphate level rises too much, it can upset the balance of calcium in your body and lead to thinning of the bones.

You may be advised to limit the amount food you eat which are high in phosphate, such as
red meat, dairy products, eggs and fish.

If this does not lower your phosphate level enough, you may be given medicines called phosphate binders. Commonly used medicines include calcium acetate and calcium carbonate.

Some people with CKD also have low levels of vitamin D, which is necessary for healthy bones.

If you're low in vitamin D, you may be given a supplement called colecalciferol or ergocalciferol to boost your vitamin D level.

Glomerulonephritis

Kidney disease can be caused by inflammation of the filters inside the kidneys, known as glomerulonephritis.

In some cases this happens as a result of the immune system mistakenly attacking the kidneys.

If a kidney biopsy finds this is the cause of your kidney problems, you may be prescribed medicine to reduce the activity of your immune system, such as a steroid or a medicine called cyclophosphamide.

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Kidney transplant

An alternative to dialysis for people with severely reduced kidney function is a kidney transplant.

This is often the most effective treatment for advanced kidney disease, but it involves major surgery and taking medicines (immunosuppressants) for the rest of your life to stop your body attacking the donor organ.

You can live with one kidney, which means donor kidneys can come from living or recently deceased donors.

But there's still a shortage of donors, and you could wait months or years for a transplant.

You may need to have dialysis while you wait for a transplant.

Survival rates for kidney transplants are very good. About 90% of transplants still function after 5 years and many work usefully after 10 years or more.

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Supportive treatment

You'll be offered supportive treatment if you decide not to have dialysis or a transplant for kidney failure, or they're not suitable for you. This is also called palliative or conservative care.

The aim is to treat and control the symptoms of kidney failure. It includes medical, psychological and practical care for both the person with kidney failure and their family, including discussion about how you feel and planning for the end of life.

Many people choose supportive treatment because they:

are unlikely to benefit from or have a good quality of life with treatment

do not want to go through the inconvenience of treatment with dialysis

are advised against dialysis because they have other serious illnesses, and the negative aspects of treatment outweigh any likely benefits

have been on dialysis, but have decided to stop this treatment

are being treated with dialysis, but have another serious illness, such as severe heart disease or stroke, that will shorten their life

Supportive care through the kidney unit can still help you to live for some time with a good quality of life.

Doctors and nurses will make sure you receive:

medicines to protect your remaining kidney function for as long as possible

medicines to treat other symptoms of kidney failure, such as feeling out of breath, anaemia, loss of appetite or itchy skin